玻璃体视网膜联合手术治疗复杂性眼外伤

Vitreo-retinal surgery for severe ocular trauma

目的探讨玻璃体视网膜联合手术治疗复杂性眼外伤的手术方法。方法2006年9月至2007年9月83例复杂性眼外伤，进行玻璃体视网膜联合手术。对合并白内障影响后段手术操作者，先行晶状体切除术或晶状体超声粉碎术；合并眼内异物者，用异物镊摘出之；合并前部增生性玻璃体视网膜病变者，行周边部视网膜切开，并取出视网膜下增生膜或增生条索，同时行巩膜环扎术。最后根据视网膜情况行长效气体或硅油等充填玻璃体腔；无晶状体眼则视视力恢复情况行二期人工晶状体植入术。术后随访12—24个月，观察视网膜复位及视力恢复情况。结果视网膜完全复位77眼，视网膜部分复位、硅油维持跟3跟，低眼压、硅油维持眼2眼，眼球萎缩者1眼。术后视力提高者68眼，不变13眼，下降2眼。其中矫正视力0．5以上者22眼，0．1～0．4者37眼，最佳矫正视力为1．0。结论玻璃体视网膜联合手术是治疗复杂性眼外伤的理想方法，可有效保留伤眼，挽救、改善患眼的视功能。

Objective To explore the method and effect of vitreo-retinal surgery forsevere ocular trauma. Methods 36 cases （40 eyes） of glaucoma 83 patients （83 eyes） with severe ocular trauma were treated with vitreo - retinal surgeries from September, 2006 to September, 2007 in our hospital. Followed up from 12 to 24 months, the retina and eyesight were observed. Results All were successfully operated on. Retinas were completed attached in 77 eyes. Visual acuity was improved in 68 eyes in different degrees and reached 0.1 or better in 59 eyes. The best visual acuity was 1.0. Conclusion Vitreo-retinal surgery is aneffective method for severe ocular traumas, and by it the severely injured eyes can be effectively saved and the visual acuity can be improved.